FROM THE FIELD: Survival in Yemen against all odds

Fawaz, just 18-months old, suffered from severe acute malnutrition and was on the brink of death. In war-torn Yemen, he was one of hundreds of thousands of children, more likely to die, than survive.

After almost four years of brutal conflict, the health care system in the country has been decimated: doctors struggle to get paid, medicines are extremely rare, inflation has rendered the most basic commodities prohibitively expensive.

For Fawaz and his parents who were watching him waste away helplessly, this could have meant the end, but against all odds, he was able to access the right treatment.

Here’s his extraordinary story, from our colleagues at the UN humanitarian coordination office (OCHA), and the camera lens of photographer, Giles Clarke.




‘Maintain calm’ and ‘exercise patience’ UN envoy urges, as Nigeria heads to polls

As Nigerians get ready to head to the polls on Saturday, the Head of the UN Office for West Africa and the Sahel (UNOWAS), described the pre-election period as “largely, peaceful and participatory”, and called for that spirit to prevail through election day and beyond.

In a statement on Friday, Mohammed Ibn Chambas, who is also the Secretary-General’s Special Representative for West Africa, encouraged all Nigerians to “continue to maintain calm and to exercise patience and restraint throughout the voting process and the announcement of the final results”.

As President Muhammadu Buhari aims to extend his time in office, after victory four years ago – when, for the first-time ever, an opposition candidate defeated a sitting president – former Vice President Atiku Abubakar has emerged as his main challenger, according to news reports.

Adhere to the tenets of free, fair, transparent, inclusive and credible elections – UN envoy

Mr. Chambas welcomed the candidates’ signing on Wednesday of the second National Peace Accord, which aims to keep the vote peaceful and ensure a non-violent transfer of power, and urged them to “seek redress of any grievances they may have through legal and constitutional means”.

He pressed the candidates to “mobilize” their supporters to “adhere to the tenets of free, fair, transparent, inclusive and credible elections, devoid of hate and denigration of each other”.

“Firmly reject all undemocratic and negative voices that may seek to disrupt the elections and promote conflict between Nigerians”, he said, while encouraging voters in Africa’s most-populous democracy to exercise their civic responsibility and come out “in numbers” to peacefully cast their votes.

The Special Representative said that success at the polls was “the responsibility of all Nigerians and relevant Nigerian institutions, particularly the Independent National Electoral Commission (INEC), security agencies, political parties, candidates, religious leaders, civil society”.  

While calling on all participants to “prioritize the interest of the country”, the UNOWAS head expressed his hopes that the continent’s largest economy will successfully conduct free, fair and transparent elections that will “set an example for the elections coming up in West Africa and Africa, and underscore Nigeria’s leadership in the region”.




Country origin ‘best predictor of outcome’ for children with cancer, UN experts say

Each year, an estimated 215 000 cancers are diagnosed in children under-15, and about 85 000 cancers in those aged 15–19 years, the cancer research agency of the World Health Organization (WHO) said on Thursday.

In a statement released to coincide with International Childhood Cancer Day, marked globally on 15 February to raise awareness of the illness, the International Agency for Research on Cancer (IARC) said that providing better data would help reduce the burden of childhood cancer.

“To combat childhood cancer and inequality, the scale of the problem must be known”, UN experts warned, remarking that in “low-resource settings, survival rates are only about one quarter those in high-resource settings”. If in high-income countries, 80% of patients can be cured, in low and middle-income countries, only about 20% of children with cancer will survive.

According to the UN agency, the inequalities are due to a lack of awareness among health professionals, as well as a lack of efficient medical infrastructure and diagnostic and treatment facilities. Hence, “country of residence is the best predictor of outcome for children with cancer”, experts note.

According to WHO, proper and timely medical care would increase the survival rates significantly, but many young people in those countries are not receiving the right treatment.

High-quality data is critical to better combat the disease worldwide

Also, the lack of infrastructure and high-quality cancer registries in many low-income countries means that data outlining the burden of childhood cancer are scarce. For example, information on cancer incidence is available for only 5% of Africa’s child population, and survival rates are available for an even smaller percentage.

WHO data shows that compared with adults, children are affected by different types of cancer. Almost half of childhood cancers are blood cell-related, and the most frequent other malignancies are tumours of the central nervous system and tumours that develop from embryonal tissues.

To help better understand and fight childhood cancer, IARC has joined the recently formed WHO Global Initiative for Childhood Cancer, which seeks to reduce inequalities in access to diagnosis and in quality of treatment, and improve treatment outcomes for all children.

According to IARC scientist Dr. Eva Steliarova-Foucher, the research agency is able set to offer “valuable technical support to help countries build their information systems and use data on cancer incidence, survival, and mortality for cancer control planning, monitoring, and evaluation.”

“Many countries are unaware of the extent of the childhood cancer burden,” IARC Director Dr. Elisabete Weiderpass added, pointing out that “the lack of high-quality data prevents governments from identifying efficient public health policies and responding to the needs of the patients”.

The Global Initiative is aiming for a survival rate of at least 60% for children with cancer globally, by 2030. This target represents an approximate doubling of the current survival rate and reaching it will save a million young lives over the next decade.




UN and partners appeal for $920 million to meet ‘dire needs’ of Rohingya refugees

With more than 745,000 Rohingya having fled violence in Myanmar to settle in Bangladesh, joining roughly 200,000 others already sheltering there, United Nations aid agencies and partners launched an appeal on Friday to help meet their “dire needs”.

The 2019 Joint Response Plan for the Rohingya humanitarian crisis seeks to raise $920 million to assist more than 900,000 refugees from Myanmar and the more than 330,000 vulnerable Bangladeshis hosting them.

“Our humanitarian imperative today is to stabilize the situation of stateless Rohingya refugees and their Bangladesh hosts”, said Filippo Grandi, UN High Commissioner for Refugees (UNHCR). “We are hoping for timely, predictable and flexible contributions in order to meet the goals of this year’s appeal”.

Critical aid and services, such as food, water, sanitation and shelter, represent more than half of this year’s funding needs, which include health, education, child protection and addressing sexual and gender-based violence.   

 “The solidarity shown by the Government of Bangladesh and the commitment of humanitarian partners ensured the successful implementation of the first Joint Response Plan in 2018”, said António Vitorino, Director General of the International Organization for Migration (IOM). “Moving forward, we reiterate our commitment to meeting the dire needs of this population and urge the international community to support these efforts”.

The new plan brings together 132 partners – UN agencies, international and national non-governmental organizations (NGOs) and government bodies – to protect refugee women, men, girls and boys, provide life-saving assistance and foster social cohesion.

“But while we tackle these immediate humanitarian needs we must not lose sight of solutions”, Mr. Grandi stressed, repeating his call that Myanmar “take urgent action to address the root causes of this crisis which have persisted for decades, so that people are no longer forced to flee and can eventually return home in safety and dignity”.

Life for Rohingya, still precarious

The third joint humanitarian appeal builds on achievements made to further stabilize the situation of Rohingya refugees.

Over the past year, the 2018 plan has supported aid agencies in improving conditions across refugee settlements by providing basic assistance, upgrading living conditions and carrying out disaster risk mitigation measures for monsoon and cyclone seasons.

Despite these and other achievements, the Rohingya remain in an extremely precarious situation.

UNHCR underscored that until the root causes of displacement in Myanmar are addressed and refugees can voluntarily return in safety, Bangladesh must be supported to meet the needs of refugees and the host communities.

As an example, the entire refugee population received basic emergency shelter kits to cope with the 2018 rainy season, but they now require safer and more robust shelters.

Similarly, while some 860,000 refugees regularly receive food assistance, only 240,000 manage to diversify their diet beyond the minimum package of rice, lentils and oil, which must be expanded to ensure better nutrition.

Moreover, continued investments into safe water and sanitation, health and protection services are vital.

“We encourage countries in this region and beyond to show solidarity with Bangladesh and to support Myanmar to start creating conditions for voluntary, safe and dignified return of Rohingya refugees” concluded the UNHCR chief.

The 2018 plan was funded at 69 per cent, or $655 million received against $950 million requested.




Biggest ever UN aid delivery in Syria provides relief to desperate civilians

The biggest UN humanitarian convoy yet to operate inside Syria has successfully distributed aid to 40,000 desperate people in a hard-to-access desert camp near the country’s southern border with Jordan, the Organization announced on Friday.

Jens Laerke from the Office for the Coordination for Humanitarian Affairs (OCHA), highlighted that Thursday’s delivery to Rukban was only the second time the UN has been able to reach the remote site from within Syria, where at least eight children had recently died, and some women have had to resort to “survival sex” just to stay alive.

“It was a complex, large-scale aid operation, it’s the biggest ever carried out by the United Nations in Syria,” he said, adding that it was carried out with UN partner the Syrian Arab Red Crescent (SARC).

“The mission lasted nine days, it consisted of 133 trucks in total, 118 loaded with relief supplies and 15 carrying logistics support,” he said. “With more than 300 staff, volunteers and commercial suppliers that took part. It took more than two months of advocacy and negotiations with all parties to ensure safe access.”

One of Syria’s most challenging places to reach

Rukban is around 300 kilometres from the capital Damascus and one of the last remaining remote and hard to reach locations, in dire need of regular aid from the UN and partners.

Some women are subjected to serial marriages and some told us they had turned to survival sex as a last resort, UNHCR’s Andrej Mahecic

Supply routes are often blocked and the majority of people at the site are displaced women and children who have been living there for years in harsh conditions, according to the World Food Programme (WFP).

Spokesperson Hervé Verhoosel said in a statement that amid significant poverty and a lack of basic goods, many families lack firewood and “end up collecting garbage and plastic to make a fire to cook and keep warm”.

Children ‘walk barefoot in puddles’

Prices of the limited food and non-food items “are exponentially high”, the UN food agency added, and commodities have to be smuggled into the market – a drastic situation underlined by the UN refugee agency (UNHCR), which described children “walking around barefoot through puddles and mud, in cold and the rain. The winter months has obviously been hard on these people and there also fatalities among the youngest”.

Spokesperson Andrej Mahecic added that in order to survive, early marriages were also “common” for girls.

“Some women are subjected to serial marriages and some told us they had turned to survival sex as a last resort,” Mr. Mahecic explained, noting also that many women were “essentially terrified to leave their mud huts or tents and to be outside, as there are serious risks of sexual violence, sexual abuse and harassment”.

Newborns at mortal risk amid freezing temperatures

The UN Children’s Fund (UNICEF) also highlighted the deadly cost of a lack of basic medical care in Rukban.

“There are no certified doctors and only a few poorly supplied clinics,” said spokesperson Christophe Boulierac. “Since December last year, at least eight children – most of them newborns – died in the camp because of freezing temperatures and lack of medical care.”  

According to UNICEF, 30 of the convoy’s 118 trucks were loaded with the agency’s life-saving supplies for children.

This included health and nutrition supplies for around 20,000 children and mothers, hygiene kits for more than 40,000 people, recreational kits, school books, stationery and school bags for more than 8,000 children.

After almost eight years of war in Syria, hundreds of thousands of people have been killed and millions have been displaced inside and outside the country.

UN will play post-war role in reconstruction, says UN Envoy

Basic infrastructure has also been destroyed and will need to be rebuilt before Syrians can go home – an issue that the United Nations would “definitely contribute to”, depending “of course on the donor community to be able to move forward”, UN Special Envoy for Syria, Geir Pedersen, told journalists in Geneva.

“Obviously for Syria to come out of the crisis we need a comprehensive approach,” he said. “And obviously that approach should lead to the IDPs (internally displaced people) being able to return to their homes, the refugees being able to return to their homes, but of course there are certain requirements for that to happen and the voluntary return of refugees, will be important for the future of Syria.  And hopefully then we can have a political process that will enable this to happen.” 

Asked about the likelihood of a meeting of the Constitutional Committee in the Swiss city, in line with UN Security Council resolution 2254 and its call for a genuine, credible and inclusive process to end the conflict, Mr. Pedersen said that his hope that it would meet “as soon as possible”.

Once finalized, the Constitutional Committee will comprise three groups: the Government of Syria, a broad opposition delegation; and one comprising Syrian experts, civil society, independents, tribal leaders and women.

Mr. Pedersen added: “We have had good discussions with the relevant parties, I think we had identified the challenges and we have agreed on how we should move forward and that I see as a very positive sign.”